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How to lift recumbent equine patients in the field and hospital with the UC Davis
Large Animal Lift

Article · January 2006

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 HOW-TO SESSION—MEDICINE

How to Lift Recumbent Equine Patients in the

Field and Hospital With the UC Davis Large
Animal Lift

Nicola Pusterla, DVM, Diplomate ACVIM; Gregory L. Ferraro, DVM; and

John E. Madigan, DVM, MS, Diplomate ACVIM

The UC Davis Large Animal Lift (LAL) is a lightweight and easily applied sling developed to help lift
horses in clinical and rescue situations. The LAL has been shown to be a useful device for evaluating
the standing ability of recumbent horses; it can be used alone or in combination with the Anderson
Sling Support Device (ASSD) to allow for standing support for horses with a variety of debilitating
problems. Authors’ addresses: Department of Medicine and Epidemiology, School of Veterinary
Medicine, University of California at Davis, 1 Shields Avenue, Davis, CA 95616 (Pusterla, Madigan);
and Center for Equine Health, School of Veterinary Medicine, University of California at Davis, 1
Shields Avenue, Davis, CA 95616 (Ferraro); e-mail: npusterla@ucdavis.edu (Pusterla). © 2006
AAEP.

1. Introduction sedation or short-acting, general anesthesia to as-

Equine slings have been successfully used to rescue
horses in various situations and have been described
in the literature for centuries.1 Such slings are
primarily used to raise, stabilize, and/or support a
horse that has difficulty standing and to lift a horse
for movement, transportation, or evacuation.2
Although many homemade supportive devices are
used in the field, not all slings have been evaluated
in the clinical setting and found suitable for horses.
One widely used equine sling is the Anderson Sling
Support Devicea (ASSD), which has been proven to
be a valuable aid in the care of horses with a variety
of debilitating problems such as spinal cord dysfunc-
tion, long-bone fractures, cranial trauma, vestibular
disease, and tetanus.3 The same sling has been
successfully used for helicopter rescue of horses.4
Slinging a recumbent horse with the ASSD requires
sure the safety of the patient and personnel. Addi-
tionally, its fitting is technically challenging,
because the patient needs to be rolled side to side to
allow for proper application.5 Further, the impor-
tant diagnostic and prognostic information provided
from the response of a recumbent horse to slinging is
often limited because of the heavy sedation required
with the application of the ASSD. To help with less
drastic and more common situations in the field and
clinics, the UC Davis Large Animal Liftb (LAL) has
been developed.6 This lightweight device is easy to
apply, and it lifts horses by the skeletal system.
The basic nature of the LAL makes it practical for
use by veterinarians, large-animal rescue teams,
and emergency personnel alike. The LAL is also
much more affordable than the ASSD. However,
the LAL is not meant to be used as a support system

NOTES

AAEP PROCEEDINGS Ⲑ Vol. 52 Ⲑ 2006 87

 HOW-TO SESSION—MEDICINE

Fig. 2. Front piece of the UC Davis LAL showing the proper

placement of straps 1, 2, and 4 on a mock horse.

pulled from underneath the horse’s flank with the

use of the retrieval device (Fig. 5). When the five
double straps are in place, they are hooked to the
corresponding, numbered carabiners on the bar and
adjusted in length according to the available lifting
clearance (Fig. 6). Thereafter, the horse is lifted by

Fig. 1. The UC Davis LAL consists of a counterbalance bar (A) to

which two sling components (B and C) made out of nylon straps
are attached after application. To help with application, the
straps and corresponding carabiners are numbered 1–5. The
metal strap-retrieval device (D) has a U-shaped end that allows
for the retrieval of the nylon straps from underneath the patient
without having to roll it over.

for long periods of time. Instead, for large animals

that are unable to stand, the LAL should be used in
conjunction with the ASSD.
2. Materials and Methods

Description and Application of the Lifting Device

The LAL consists of a counterbalance bar and two Fig. 3. Retrieval of strap 1 from underneath the neck of the
sling components made out of nylon straps (Fig. 1). mock horse by using the retrieval device.
The device can be easily applied by as few as one
person on the sedated or anesthetized recumbent
horse with the use of a strap retrieval device. The
device consists of a metal rod with a U-shaped end
that allows for placement of the nylon straps under-
neath the patient without having to roll it. During
the placement of the LAL, one additional person is
needed to keep control of the horse’s head. To im-
prove safety, all the steps of the application of the
LAL are performed from the backside of the horse.
After the horse is adequately restrained, the front
piece of the LAL is placed between the front legs of
the horse (Fig. 2), and the lower straps are retrieved
from underneath the horse by using the metal-strap
retrieval device (Fig. 3). Thereafter, the back piece
of the LAL is placed between the back legs of the Fig. 4. Back piece of the UC Davis LAL showing proper place-
recumbent horse (Fig. 4), and the lower strap is ment of straps 3 and 5 on a mock horse.

88 2006 Ⲑ Vol. 52 Ⲑ AAEP PROCEEDINGS


Fig. 5. Retrieval of strap 3 from underneath the flank of the
mock horse by using the retrieval device. Figure reprinted with
permission from the Swiss Journal of Veterinary Medicine. Pus-
terla N, Madigan JE. Initial clinical impressions of the UC Davis
large animal lift and its use in recumbent equine patients.
Schweiz Arch Tierheilk 2006;148:161–166.
its skeletal system with the use of a manual or
electric hoist in a hospital stall, backhoe forklift, or
other crane-like machine in the field. It is advis-
able to use tail, head, and leg ropes to assist the
horse during lifting whenever possible. Further, to
prevent horses from leaping forward during the lift-
ing procedure, a corner strap can be used to secure
the LAL to one corner of a stall. After the horse is
lifted, its standing ability should be evaluated.
Care must be taken not to keep horses that are
unable to bear weight hanging in the LAL for ⬎20
min.
Equine Patients
LAL application and lifting attempts were recorded
for 17 horses over a period of 20 mo. The procedure
was performed in these horses to assess their ability
to stand and provide important diagnostic and prog-
nostic information. Additionally, the LAL was
Fig. 6. Dorsal view of the mock horse showing the five double
straps hooked to the corresponding numbered carabiners.
HOW-TO SESSION—MEDICINE
used to elevate these horses for easier application of
a more permanent slinging device. Thirteen proce-
dures were performed at the Veterinary Medical
Teaching Hospital (VMTH), School of Veterinary
Medicine in Davis, whereas four procedures were
performed in the field at the request of private own-
ers. For every procedure, the patient’s history, se-
dation (drugs used, dosage of each drug), ease and
time of LAL application and hoisting, standing abil-
ity post-hoisting, LAL tolerance, and outcome were
recorded.
The 17 horses ranged in age from 5 mo to 20 yr
(mean ⫾ SD ⫽ 9.9 ⫾ 7.7 yr) and were comprised of
9 mares and 8 geldings. Seven were Quarter
Horses, and the remaining were Percheron (3), Ara-
bian (3), Appaloosa (2), Mustang (1), and American
Paint Horse (1). The patient’s weight was recorded
for 15 of 17 horses, and their weights ranged from
170 to 1000 kg (516 ⫾ 219 kg). The 17 patients
were diagnosed with the following conditions:
West Nile virus encephalitis (5), cervical spine my-
elopathy (2), hyperkalemic periodic paralysis (2),
spinal cord trauma (2), spinal cord neoplasia (1),
equine protozoal myeloencephalitis (1), tetanus (1),
polysaccharide storage myopathy (1), semi-membra-
nosus muscle tear (1), and severe hindlimb osteoar-
throsis (1).
3. Results
The time from recumbency to application of the LAL
was recorded in all horses. Five hospitalized neu-
rologic horses were found acutely recumbent in their
stall because of the progression of their primary
disease, whereas one horse was unable to rise after
a myelogram. Seven other horses were referred to
the VMTH because of acute recumbency. These
horses had been down for 4 –17 h (7.8 ⫾ 4.8 h) on
arrival to the hospital. Four horses were presented
in the field; three of these horses had been recum-
bent for 8 – 48 h, and one horse had been recumbent
for 2 wk.
Gas anesthesia was performed in only one horse to
help perform selective diagnostics (skull and neck
radiographs and atlantooccipital cerebrospinal fluid
tap) before application of the LAL. Injectable an-
esthesia with a combination of xylazine (1 mg/kg)
and ketamine (2 mg/kg) was performed in three
horses that presented recumbent to the hospital to
safely extract them from the trailer and move them
to a stall before lifting. In seven horses (four
acutely recumbent in the hospital, one recumbent in
the trailer, one recumbent in the field, and one un-
able to stand after a myelogram), xylazine (0.3– 0.5
mg/kg) was the sole drug used to sedate these horses
before application of the LAL. A combination of
detomidine (0.01 mg/kg) and butorphanol (0.01 mg/
kg) was used one time before moving a recumbent
horse from the trailer to a stall before application of
the LAL. In a total of five horses (three recumbent
in the field, one acutely recumbent in the hospital,
and one referred to the hospital), no sedation was
AAEP PROCEEDINGS Ⲑ Vol. 52 Ⲑ 2006 89
 HOW-TO SESSION—MEDICINE
Fig. 7. Twenty-year-old Quarter Horse gelding able to stand
after being lifted with the UC Davis LAL. Figure reprinted with
permission from the Swiss Journal of Veterinary Medicine. Pus-
terla N, Madigan JE. Initial clinical impressions of the UC Davis
large animal lift and its use in recumbent equine patients.
Schweiz Arch Tierheilk 2006;148:161–166.
used during the application of the LAL and lifting
procedure.
The LAL was applied without any technical prob-
lems in 16 horses. In the largest horse, a 1000 kg
Percheron gelding, the number 4 straps had to be
extended by using two extension straps to fit the
horse. In all of the 17 horses, the LAL was applied
in ⬍5 min. Hoisting was performed without any
problem in all cases with an electric hoist (13 horses)
in the hospital and a backhoe (3 horses) or a manual
hoist in the field (1 horse). Eight horses were able
to stand and bear weight after being lifted (Fig. 7).
Two horses were able to stand with assistance, but
seven horses were unable to support their weight
(Fig. 8). In all horses, the sling was well tolerated.
Fig. 8. Twenty-year-old Appaloosa gelding unable to stand after
being lifted with the UC Davis LAL in the field with the help of a
backhoe. Figure reprinted with permission from the Swiss Jour-
nal of Veterinary Medicine. Pusterla N, Madigan JE. Initial clin-
ical impressions of the UC Davis large animal lift and its use in
recumbent equine patients. Schweiz Arch Tierheilk 2006;148:
161–166.
90 2006 Ⲑ Vol. 52 Ⲑ AAEP PROCEEDINGS
Fig. 9. Eight-year-old Percheron gelding standing in the UC
Davis LAL before being moved into the ASSD. The ASSD has
been fitted on the standing horse over the UC Davis LAL. Figure
reprinted with permission from the Swiss Journal of Veterinary
Medicine. Pusterla N, Madigan JE. Initial clinical impressions of
the UC Davis large animal lift and its use in recumbent equine
patients. Schweiz Arch Tierheilk 2006;148:161–166.
Ten hospitalized horses (five standing, two standing
with support, and three unable to support weight)
were transitioned into the ASSD to allow for better
distribution of support and long-term slinging (Figs.
9 and 10), whereas three hospital patients were
euthanized at the request of their owners because of
their inability to bear weight in the LAL. Three of
the four horses lifted in the field were able to stand
without support; however, one horse was eutha-
nized, because he could not bear weight in the LAL.
Standing horses were left in the LAL until the ASSD
was applied (i.e., ⬍10 min) or ⱕ12 h in three field
horses. Because the LAL is not intended as a long-
term sling, care was taken in those three horses to
avoid pressure injuries from the nylon straps. Be-
Fig. 10. Eight-year-old Percheron gelding standing after being
transitioned into the ASSD. Figure reprinted with permission
from the Swiss Journal of Veterinary Medicine. Pusterla N, Ma-
digan JE. Initial clinical impressions of the UC Davis large ani-
mal lift and its use in recumbent equine patients. Schweiz Arch
Tierheilk 2006;148:161–166.

cause the ASSD uses a rectangular overhead sup-
port that attaches to the corresponding sling, horses
unable to stand had to be lowered to sternal recum-
bency before they could be lifted in the ASSD.
However, because the ASSD was applied while these
horses were hanging in the LAL, dropping, switch-
ing the frame, and rehoisting took ⬍10 min. In
these horses, the LAL was removed from under the
ASSD without any problems while the horses were
down. The three horses that were unable to stand
and therefore, were switched to the ASSD never
regained the ability to stand despite intensive med-
ical treatment and supportive care. They were eu-
thanized shortly thereafter.
4. Discussion
It is the authors’ opinion that recumbency should be
addressed as an emergency, and all actions should
be taken to diagnose the underlying disease.
Whenever possible, early slinging should be at-
tempted to assist a horse to its feet; this decreases
muscle damage, promotes limb usage and circula-
tion, and decreases the possibility for development
of decubital ulcers. The age of a horse is important
when considering using a lifting device, because
young horses are known to be less tolerant of such
devices.2 Although all age groups were repre-
sented in our study, only four horses were ⬍2 yr of
age, which may explain the relatively low level of
sedation used during the procedure for most study
horses.
Precautions regarding the use of slings should be
understood by the attending personnel, and sedation
and/or general anesthesia should be used when the
patient is struggling or attempting to stand up.
Blindfolding recumbent horses and working in a
quiet environment will often allow the application of
the LAL with little to no sedation. The majority of
the study cases required minimal or no sedation,
and general anesthesia was restricted to patients
needing diagnostic workup or being moved from the
trailer to the stall. Whenever sedation with an al-
pha-2 agonist may affect the ability of a weak or
uncoordinated horse to rise, the use of an alpha-2
antagonist such as yohimbine should be considered
to reverse the effects. In all circumstances, one
must remember that recumbent horses are unpre-
dictable, even when sedated; arousal or violent
activity can occur abruptly and cause injury.
Personnel should be made fully aware of this poten-
tial to minimize human injury.
The LAL can be used effectively on a recumbent
horse with as few as two people. One person should
always control the head and be in charge of sedation,
if needed, and at least one person should apply the
sling components. The advantage of the LAL is
that all steps can be performed by working from the
back side of the patient. This prevents any unnec-
essary risk of injury to personnel from standing
between the legs of the recumbent horse. Because
of the simplicity of the LAL, application took ⬍5 min
HOW-TO SESSION—MEDICINE
in all horses. In the case of a large horse (adult
draft horse), the sling components may be too short
to allow attachment to the counterbalance bar, but
they can be extended with two adjustable nylon
straps to allow for proper sling fitting. This situa-
tion was only encountered one time in our study
when applying the LAL to a 1000-kg Percheron geld-
ing. When hoisting horses, control of the head
should be ensured by using one or two ropes at-
tached to the halter. As an alternative, head and
tail rope recovery can help assist patients during the
lifting and allow for better protection of attendants.
Personnel should not stand in front of the horse
when it is being lifted, because horses with hindlimb
weakness tend to leap forward when they regain
consciousness. To prevent horses from moving for-
ward, we do recommend using nylon straps attached
from one corner of a stall to the caudal part of the
counterbalance bar whenever possible.
Evaluating the ability of a recumbent horse to
stand may provide important diagnostic and prog-
nostic information. The best scenario was encoun-
tered in 10 study cases that were able to stand and
bear weight. These horses tolerated the LAL with-
out any problems and never became violent or tried
to escape the sling. At the hospital, seven standing
horses were transferred to the ASSD, which pro-
vides better long-term support. This was per-
formed by applying the ASSD over the LAL and
replacing the counterbalance bar with the rectangu-
lar overhead support. After the standing horses
were secured to the ASSD with the appropriate sling
components, the LAL was removed. The total pro-
cedure took ⬍5 min in all standing cases.
Three standing horses presented in the field
were left in the LAL for ⱕ12 h. It is important in
such situations that the LAL be secured with cor-
ner straps to prevent violent activity and that
constant supervision be provided. The LAL was
very well tolerated in the three standing field
horses, and none of them tried to lay
down. Seven horses were unable to stand when
lifted. These horses were given ⱕ20 min to show
any improvement. It is important during this
procedure to assist the horse with leg ropes and to
encourage the horse to stand. Although four
horses were euthanized because of the inability to
stand, three horses were moved to the ASSD.
Applying the ASSD, lowering the horse to recum-
bency to switch the overhead frame, removing the
LAL, and relifting the horse took ⬍10 min in each
patient, and the whole procedure was well toler-
ated. Despite the use of the ASSD, these three
horses never regained weight-bearing function
and were eventually euthanized. We are aware
that horses should not hang in a sling if they are
not weight bearing; however, applying the ASSD
in a hanging position was easy and fast, and it did
not require general anesthesia as indicated for
down horses.
AAEP PROCEEDINGS Ⲑ Vol. 52 Ⲑ 2006 91
 HOW-TO SESSION—MEDICINE
In conclusion, the LAL has proven to be a valu-
able aid in lifting recumbent horses with a variety
of debilitating problems. The unique features of
this device make it easy to use in the clinic and
field setting, and it is well tolerated by the recum-
bent horse. The use of the LAL for additional
applications–recovery from anesthesia, extraction
of horses from difficult rescue-type situations
(mud, ravines, swimming pools, etc.), lifting of
older horses that cannot rise, and prevention of
horses with pelvic injuries or other orthopedic in-
juries from laying down–needs to be further
investigated.
We acknowledge Verlag Hans Huber for granting
permission to reproduce material previously pub-
lished in the Swiss Journal of Veterinary Medicine.
92 2006 Ⲑ Vol. 52 Ⲑ AAEP PROCEEDINGS
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3. Madigan J. Evaluation of a new sling support device for
horses. J Equine Vet Sci 1993;13:260 –261.
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a
Anderson Sling Support Devise, Care for Disabled Animals,
Potter Valley, CA 95469.
b
UC Davis Large Animal Lift (www.largeanimallift.com),
Large Animal Lift Enterprises, Chico, CA 95926.